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UHC Choice Plus Silver 4750-2
Health Insurance Plan Details (2024 Plan)
by UnitedHealthcare
Monthly Premium
POS
$ubsidy
Silver
- Deductible
- $4,750 /yr
- Max Out-of-Pocket
- $9,100 /yr
Details
Deductible (per individual) | $4,750 /yr |
Deductible (per family) | $9,500 /yr |
Max Out-of-Pocket (per individual) | $9,100 /yr |
Max Out-of-Pocket (per family) | $18,200 /yr |
Drug Deductible (per individual) | |
Drug Deductible (per family) | |
Drug Max Out-of-Pocket (per individual) | |
Drug Max Out-of-Pocket (per family) | |
Plan Type | POS |
Includes Child Dental? | Yes |
Includes Adult Dental? | No |
Out-of-Pocket Costs
Preventive Care | No Charge |
Primary Care Visit | $40 Copay |
Specialist Visit | $85 Copay |
Emergency Room | 30.00% Coinsurance after deductible |
Inpatient Facility | 30.00% Coinsurance after deductible |
Inpatient Physician | 30.00% Coinsurance after deductible |
Generic Drugs | $15 Copay |
Preferred Brand Drugs | $60 Copay |
Non-preferred Brand Drugs | $150 Copay |
Specialty Drugs | $150 Copay |
Plan Documents
Summary of Benefits and Coverage | SBC doc |
Provider Directory | Doctor lookup |
Drug Formulary List | n/a |
* Figures shown are only for in-network medical costs
** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible
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